How much rates vary
Facilitymedian $1,660 · 10th to 90th $575 to $7,762Professionalmedian $398 · 10th to 90th $263 to $537
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $331.13 Median $1,380.38 Typical High $7,762.47 | Facility | None | $331.13 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $416.87 | Professional | None | $302.00 | $416.87 | $416.87 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,737.80 Median $6,165.95 Typical High $9,549.93 | Facility | None | $1,737.80 | $6,165.95 | $9,549.93 |
BCBS New Mexico Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $562.34 | Professional | None | $275.42 | $398.11 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,513.56 | Facility | None | $776.25 | $1,174.90 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $512.86 | Professional | None | $302.00 | $354.81 | $512.86 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $93.33 Typical High $467.74 | Professional | None | $33.11 | $93.33 | $467.74 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $1,148.15 Typical High $1,778.28 | Facility | None | $288.40 | $1,148.15 | $1,778.28 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $562.34 | Professional | None | $309.03 | $363.08 | $562.34 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $575.44 | Professional | None | $269.15 | $436.52 | $575.44 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $151.36 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $60.26 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $223.87 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $45.71 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $30.20 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $208.93 | $288.40 | $288.40 |
Where New Mexico sits
The same service costs 4.6 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $4,822MT $1,050
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.